Organization
ST. CROIX PSYCHOLOGICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN B. HAMANN ED.D (WI LIC. PSYCHOLOGIST)
(715) 425-7031
Entity
Organization
Contact information
Practice address
258 RIVERSIDE DR, RIVER FALLS, WI 54022-3236
(715) 425-7031
(715) 425-1055
Mailing address
PO BOX 425, RIVER FALLS, WI 54022-0425
(715) 425-7031
(715) 425-1055
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
371-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427168079
NPI
—
05
—
39062200
—
WI
Enumeration date
12/18/2007
Last updated
12/18/2007
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